Organization
COLLABORATIVE & INNOVATED CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELA CLARIDA (OWNER)
(843) 222-5395
Entity
Organization
Contact information
Practice address
1016 2ND AVE N STE 203A, NORTH MYRTLE BEACH, SC 29582-3288
(843) 222-5395
(866) 340-0296
Mailing address
1016 2ND AVE N STE 203A, NORTH MYRTLE BEACH, SC 29582-3288
(843) 222-5395
(866) 340-0296
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/29/2024
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